Bone Mass

Question 1

do men or women have a lower peak density?

Answer 1

Women

Question 2

What is the peak age range for bone mass?

Answer 2

30-40

Question 3

T/F younger ages are more at risk for fractures

Answer 3

False, older

Question 4

T/F postmenopausal women have a greater bone mass loss

Answer 4

True

Question 5

osteopenia

Answer 5

thinning of trabecular matrix of bone before osteoporosis

T score -1-2.5

Question 6

Osteoporosis

Answer 6

bone mineral density -2.5 below peak bone mass

Increased bone fragility more susceptible for fractures

Question 7

What scan is used to diagnose osteoporosis

Answer 7

DEXA
T score

Question 8

risk factors for osteoporosis

Answer 8

Increased age
History of fractures, adult
Postmenopausal women
Family History
Asian, Caucasian
Low weight– thin frame
Smoking, alcohol
Lack of weight-bearing exercise
Decreased calcium, vitamin D, estrogen, testosterone
Increase caffeine

Long-term corticosteroid therapy
Immunosuppressive drugs
Eating disorders
Gastric bypass surgery

Question 9

FRAX tool

Answer 9

prediction to assess risk of a fracture

Provides treatment guidelines

Calculates ten year risk score

Question 10

Patho of osteoporosis

Answer 10

bone resorption – osteoclasts
bone formation – osteoblasts

Inability to make new bone
Increased resorption
Or both

Question 11

T/F there are many early signs and symptoms of osteoporosis

Answer 11

False

Question 12

Later S/SX osteoporosis

Answer 12

fracture
Pain
Decreased height
Stooped posture – kyphosis

Question 13

common Types of fractures

Answer 13

Most common – vertebrae
Hip – upper end of femur
Wrist

Question 14

Is there a high likelihood of death after a fall?

Answer 14

Yes, for older women

Hospitalized over 65 years

Question 15

risk factors for hip fracture

Answer 15

Over 65
Female
Osteoporosis
Frequent falls

Femoral neck injury

Question 16

s/sx hip fracture

Answer 16

Sudden onset hip pain before or after fall

Inability to walk
Severe groin pain
Affected leg, externally, rotated, and shorter

Question 17

What are complications of hip fractures?

Answer 17

infection – UTI/pneumonia
VTE

Question 18

Prevention of hip fractures

Answer 18

calcium/vitamin D, supplements

Elemental Calcium – 1200–2000 Daily
Vitamin D – 800–1000 daily
Exercise 30 minutes three times a week

Question 19

Fracture

Answer 19

Any break in continuity of bone that occurs when more stress is placed on bone then it can absorb

Question 20

causes of fractures

Answer 20

Trauma
Fatigue, prolonged stress

Weak bone – spontaneous break – high risk in elderly

Question 21

Description of fracture

Answer 21

name of bone
Location
Orientation of fracture
Alignment – displaced/not
Condition of overlying tissue – open/closed

Question 22

T/F a closed fracture breaks through the skin

Answer 22

False

Question 23

s/sx fracture

Answer 23

PED

PAIN
EDEMA – supportive
Deformity – loss of function, abnormal mobility

Question 24

complications of fractures

Answer 24

Delayed healing
Bone growth impairment
Compartment syndrome
Fat embolism syndrome

Question 25

delayed union

Answer 25

Pain and tender increased Risk factor – smoking, malnutrition – decreased perfusion

Question 26

Malunion

Answer 26

In proper alignment, not fully healed

Question 27

No union

Answer 27

no healing 4–6 months post fracture Causes – poor circulation, blood supply, repetitive stress

Question 28

compartment syndrome causes

Answer 28

Due to crush type injuries Cast – too tight, swelling tissue Long bone injuries Severe thermal burns Animal bites

Question 29

compartment syndrome

Answer 29

Increased pressure within limited anatomic space

Question 30

what is the tourniquet affect?

Answer 30

Edema at fracture site puts intense pressure on soft tissue Decreases perfusion Leads to hypoxia of muscles and nerves

Question 31

s/sx compartment syndrome

Answer 31

Extreme pain, rapid onset

Question 32

can compartment syndrome be relieved with a fasciotomy

Answer 32

Yes

Question 33

fat embolism syndrome

Answer 33

Fat molecules in lung with long bone fracture 24 – 48 after injury Fat molecules from bone marrow/trauma tissue released in bloodstream and enter lungs

Question 34

triad of symptoms for fat embolism syndrome

Answer 34

Hypoxemia Altered LOC Petechiae/rash

Question 35

Will the embolism dissolve on its own?

Answer 35

yes

Question 36

osteomyelitis

Answer 36

Acute/chronic pyogenic infection of bone (Pus)

Question 37

T/F osteomyelitis does not require immediate treatment

Answer 37

False

Question 38

what is the usual cause of osteomyelitis?

Answer 38

Bacteria – staph Aureas on skin

Question 39

risk factors for osteomyelitis

Answer 39

Recent trauma, bite wound Diabetes – poor circulation, decreased immune response Hemodialysis IV. Drug use. Splenectomy PVD – poor circulation

Question 40

routes of contamination

Answer 40

Open wound – open fracture, gunshot, puncture, surgery, insertion of metal plate/screws Indirect- hematogenesis, blood-borne bacteremia

Question 41

Who is more at risk for indirect contamination?

Answer 41

Kids less than 16 years old

Question 42

Patho of hematogenous route

Answer 42

Arterial blood flow brings bacteria into bone Infection results in inflammation, bone destruction, pus, edema pressure increases Ischemial necrosis Osteoblasts lay new bone around old Infection is isolated

Question 43

osteomyelitis s/sx

Answer 43

local – Tender, warm, red, wound drainage, restricted movement, spontaneous fractures Systemic – fever, positive blood culture, leukocytosis